Care Coordinator

This is a fully remote position, open to applicants in Florida, +3 more states.

📋 Description

• Take responsibility for patient cases from start to finish.

• Conduct investigations into benefits and manage prior authorizations as well as denial appeals.

• Assess financial qualifications for assistance programs.

• Support patients and stakeholders in resolving issues via email, inbound/outbound calls, and Lynk technology.

• Establish trusted relationships with patients, prescribers, and client stakeholders.

• Perform welcome calls and follow-up calls after benefit investigations to explain coverage options.

• Handle inquiries from clients and healthcare providers.

• Manage incoming calls in line with program-approved FAQs.

• Direct patients to appropriate internal or external resources.

• Offer personalized case management while communicating benefit coverage and subsequent steps.

• Identify benefits and payer coverage through electronic tools and manual investigations.

• Relay requirements for prior authorization, appeals, tier exceptions, and formulary exclusions.

• Follow up with payers and healthcare providers regarding submissions and their outcomes.

• Coordinate education and follow-up services provided by nurses.

• Identify resources for peer support.

• Manage product shipments through patient assistance and bridge programs.

• Communicate needs for prior authorization reverification and patient assistance re-enrollment.

• Report adverse events, product complaints, special situation reports, and medical inquiries according to standard operating procedures (SOPs) and business rules.

• Record activities in the PharmaCord Lynk system.

• Complete mandatory training and adhere to SOPs.

• Undertake additional assigned tasks or projects.

⛳️ Requirements

• Bachelor’s degree is strongly preferred or equivalent experience is required.

• Customer service and experience in the healthcare industry are preferred but not mandatory.

• Ability to work an 8.5-hour shift between 8 am to 9 pm, Monday to Friday, is required.

• Basic knowledge of computer systems.

• Professional telephone etiquette is essential.

• Capability to multitask effectively.

• Clear and concise communication skills.

• Detail-oriented mindset.

• Flexibility to adapt to change and take initiative.

• Service-oriented approach towards patients and care partners.

• Bilingual skills in Spanish and English are advantageous.

• Typing speed of at least 35 words per minute with 97% accuracy is preferred.

• Successful completion of a background check and, depending on the position, a drug screening.

• Eligibility for remote work is subject to work-from-home criteria and business requirements.

🏝️ Benefits

• Medical, dental, and vision plans, including HSA- and FSA-eligible options, with Valeris contributing toward premium costs.

• Access to Telehealth and Employee Assistance Program (EAP) services.

• Company matching on Health Savings Account contributions.

• Complimentary Basic Life and AD&D coverage equal to annual earnings, with a minimum of $50,000 and a maximum of $300,000.

• Company-paid Short-Term Disability coverage, with the option to purchase Long-Term Disability.

• 401(k) Retirement Savings Plan featuring a 100% match on the first 5% contributed, with immediate vesting.

• Paid Time Off (PTO) and Sick Leave.

• Nine paid holidays plus two floating holidays.

• Opportunities for advancement and personal and professional development.

• A challenging and stimulating work environment that encourages innovative ideas.

• An inclusive workplace with a mission-driven culture.

• Flexibility for minimal travel is preferred.